Rahaman Quazi Mahfuzur, Nath N C, Midya Sumit
Department of Surgery, NRS Medical College and Hospital, Calcutta 700014.
J Indian Med Assoc. 2002 Aug;100(8):522-3.
Though abdominal tuberculosis is fairly common in our country, incidence of tuberculous hepatitis is rare. The authors reported a case who presented to the surgical OPD of the NRS Medical College, Calcutta with complaints of right upper quadrant abdominal pain, flatulent dyspepsia, nausea and occasional vomiting. Ultrasonography (USG) revealed fibrotic gall bladder without any calculus suggesting chronic acalculus cholecystitis. On exploration of the abdomen, the gall bladder was found to be fibrotic and thickened without any calculus. Multiple scarred nodules of different sizes were found in the liver. Cholecystectomy was done and a scarring nodule from the liver was taken for histopathological examination which revealed a tuberculous granuloma. Histopathology of the gall bladder showed cholesterosis. The patient responded to antituberculous drugs.
虽然腹部结核在我国相当常见,但结核性肝炎的发病率却很罕见。作者报告了一例患者,该患者因右上腹腹痛、肠胃气胀性消化不良、恶心和偶尔呕吐而就诊于加尔各答NRS医学院外科门诊。超声检查(USG)显示胆囊纤维化,无任何结石,提示慢性无结石性胆囊炎。在腹部探查时,发现胆囊纤维化且增厚,无任何结石。肝脏中发现多个大小不同的瘢痕结节。进行了胆囊切除术,并取肝脏的一个瘢痕结节进行组织病理学检查,结果显示为结核性肉芽肿。胆囊的组织病理学显示有胆固醇沉着症。患者对抗结核药物有反应。